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How far apart can you take ibuprofen and Tylenol?

The short answer

The recommended dose interval of Tylenol is every 6 hours. While the recommended dose interval of ibuprofen is every 8 hours. Therefore, you can separate between the dose of ibuprofen and Tylenol by 3-4 hours.

Key facts:

  • The recommended dose interval of Tylenol is every 6 hours. While the recommended dose interval of ibuprofen is every 8 hours.
  • You can separate between the dose of ibuprofen and acetaminophen by 3-4 hours.
  • The maximum daily dose of ibuprofen is 1200 mg for over-the-counter uses. However, the maximum prescribed dose of ibuprofen is 3200 mg per day.
  • For acetaminophen, the maximum dose is up to 400 mg per day.
  • Acetaminophen greater than 7 g for an adult and 150 mg/kg for a child is considered potentially toxic to your liver and kidneys.
  • Ibuprofen with a dose of more than 400 mg/kg in a child is associated with serious or life-threatening toxicity.

Content

Why are ibuprofen and Tylenol taken together?

How far apart can you take ibuprofen and Tylenol?

How much Tylenol and ibuprofen can I take together per day?

Overdose of acetaminophen

Overdose of ibuprofen

Why are ibuprofen and Tylenol taken together?

Both ibuprofen and Tylenol are used to relieve pain. However, better outcomes have been reported when ibuprofen and Tylenol are administered together in an alternative manner.

Ibuprofen and Tylenol work through two different mechanisms, therefore, when they are administered together, they have a synergistic effect.

Ibuprofen is a nonsteroidal anti-inflammatory drug that acts by inhibiting the action of cyclooxygenase enzymes which are responsible for the production of prostaglandins and thromboxane that mediate pain and inflammation.

In contrast, the reduction of the COX pathway activity by Tylenol is thought to inhibit the synthesis of prostaglandins in the central nervous system, leading to its analgesic and antipyretic effects (Ref).

These two different mechanisms of both ibuprofen and Tylenol enhance their effects when they are administered together.

How far apart can you take ibuprofen and Tylenol?

The peak plasma concentration of acetaminophen (Tylenol) at 30 minutes after oral administration. While the peak plasma concentration of ibuprofen is 60 minutes after oral administration.

The recommended dose interval of acetaminophen is every 6 hours. While the recommended dose interval of ibuprofen is every 8 hours (Ref).

Accordingly, you can separate between the dose of ibuprofen and acetaminophen by 3 hours. So, if you need to alternate between ibuprofen and Tylenol you can do as follows.

Take ibuprofen at 12 pm, Tylenol at 3 pm, ibuprofen at 6 pm, Tylenol at 9 pm, and then ibuprofen at 12 am.

How much Tylenol and ibuprofen can I take together per day?

You can take ibuprofen and Tylenol together safely if you don’t exceed the maximum daily doses.

For children:

The dose is determined according to the weight.

For adults

The maximum daily dose of ibuprofen is 1200 mg for over-the-counter uses. However, the maximum prescribed dose of ibuprofen is 3200 mg per day.

For acetaminophen, the maximum daily dose is up to 4000 mg per day.

Therefore, when you take ibuprofen and acetaminophen together, you shouldn’t exceed the maximum daily dose of each one.

Overdose of Tylenol

Acetaminophen is indicated for fever and for the relief of mild to moderate acute pain

The maximum recommended therapeutic dose of acetaminophen is 4000 mg per day in adults and 50–75 mg/kg/day in children (Ref).

The plasma half-life of acetaminophen is 1.5–2.5 hours at the recommended doses. However, after acetaminophen overdose, its metabolism is impaired and the half-life is prolonged to 4–8 hours and this is directly related to the extent of the liver injury.

Acetaminophen overdose is one of the most common drug-related toxicities reported to poison centers.

If you take a single dose of acetaminophen greater than 7 g for an adult and 150 mg/kg for a child it is considered potentially toxic to your liver and kidneys due to the highly active metabolite, N-acetyl-p-benzoquinone imine of acetaminophen (Ref).

Acetaminophen has been reported to be the main cause of acute liver failure in the United States (Ref). Therefore, the United States Food and Drug Administration (FDA) has limited the acetaminophen content of prescription tablets to 325 mg. Accordingly, when you take eight tablets of acetaminophen, this means you just consumed 2600 mg per day.

Overdose of ibuprofen

Ibuprofen is one of the most commonly used and prescribed medications in the world. In the United States, 9% of overdoses among adults reported to poison centers were from ibuprofen ingestion (Ref).

Ibuprofen is available in the markets as tablets with strengths ranging from 200 to 800 mg.

Ibuprofen has a short half-life of 1.8 to 2 hours. It is completely metabolized and eliminated within 24 hours.

The peak plasma concentration after oral administration is 1 to 2 hours and the onset of analgesic action starts 30-60 minutes following oral ingestion.

The onset of antipyretic action (to reduce fever) varies with age ranging from less than an hour in adults to up to 3 hours in children

No symptoms of ibuprofen toxicity in doses less than 100 mg/kg for children. However, taking ibuprofen with a dose of more than 400 mg/kg in a child is associated with serious or life-threatening toxicity (Ref).

No specific cutoff distinguishes asymptomatic from symptomatic overdose in adults.

The symptoms of ibuprofen toxicity can start 4 hours after administration of too much ibuprofen.

Interestingly, less than 1% of ibuprofen overdose is fatal and the majority are not life-threatening.

Symptoms of ibuprofen overdose are the following:

  • Heartburn
  • Nausea
  • Vomiting
  • Dizziness
  • Blurred vision
  • Sweating
  • Slow breath
  • Hypotension
  • Seizures
  • Coma

In case you take too much ibuprofen, acetaminophen, or any other medications, it is important to call the poisoning center immediately and you shouldn’t wait until symptoms start.